Medicare Resources

     

    Want to do your own research first?

    Here are some resources on Medicare.

     

    Medicare is basically an 80/20 plan with deductibles.

     

    Medicare Part A will pay for inpatient hospital stays after a $1,288 deductible.

     

    Part B will pay 80% (after an annual deductible of $166) for outpatient physician and surgical services, tests, therapy, diagnostic procedures and more.

     

    Part C Medicare Advantage combines A, B & D. You pay copayments.

     

    There are 3 phases of Medicare Part D Drug Coverage:

     

    1) Initial Phase - you will pay the copays until the total cost of your drugs reaches $3,700. The total cost is the amount that you have paid plus the amount your insurance company has paid.

     

    2) Coverage Gap - the "doughnut hole" begins after your drug costs have reaached $3,700 (the amount you and your insurance company have paid).

     

    The starting point for the doughnut hole is the amount you paid during the initial phase. For example, if you paid $500 in copayments during the initial phase, then your coverage gap would start at $500 and last until $4,950.

     

    Example: you start at $500 and last until $4,950, you will pay 40% for brand and 51% for generics. Example: if a prescription retails at $200, then you would pay $80. $200 would count toward the "tiering" (not the $90 that you paid) - that is how you get from the $500 starting point to $4,950.

     

    3) Catastrophic Phase - beginning at $4,951, your cost reduces to either 5% or 8.25% for brand drugs, and $3.30 or $7.40 for generic drugs.

     

    Links

     

    Social Security

     

    Medicare

     

    Medicare - Get help paying costs

     

    "Medicare 101" Excerpt from the 2017 Medicare and You handbook from Social Security:

    Medicare Information

    Click on https://www.medicare.gov/medicare-and-you/medicare-and-you.html for your full copy.

     

    Claims and Appeals

     

    What Medicare covers

     

    Your Medicare costs

     

    mark@keepingmedicaresimple.com

     

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